| NPI | 1407826175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 117452-4) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND 4874) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-07-08 |